Birth Control Patch (Ortho Evra®)

What is The Patch?

"The Patch" is a matchbook size, beige colored contraceptive patch that contains both estrogen and progestin. It releases 150mg of norelgestromin (progestin) and 20mg of ethinyl estradiol (estrogen) every 24 hours.

Initiating Use:

Use of the patch can be started on the Sunday following the onset of menses or on the first day of the normal menses (same as oral contraceptive use). It is applied to clean, dry skin on the buttocks, abdomen, or upper outer arm. it cannot be applied to the breast or to irritated skin. The area where the patch will be placed cannot be covered with powder, lotion, or other products which might interfere with its usage. Patients should not use any of these products on or near a patch.

Schedule of Use:

The patch is in place for 7 days an then replaced. It is applied each week on the same day for 3 weeks, followed by a patch-free week, when a withdrawal bleed will occur.

Effectiveness:

Effectiveness rates equal to the pill, with perhaps better tolerance and consistent use.

Contraindications:

• Similar to oral contraceptives
• Thrombophlebitis
• History of DVT
• Valvular heart disease or complications
• Migraines with vascular involvement/focal aura
• Known or suspected breast cancer, history of breast cancer
• Estrogen dependent neoplasia
• Hepatic adenoma carcinoma
• Known or suspected pregnancy
• Hypersensitivity to product
• Cholestatic jaundice of pregnancy or jaundice with prior hormonal use
• Severe hypertension
• Diabetes with vascular involvement
• Major surgery with prolonged immobilization
• Undiagnosed abnormal genital bleeding

Advantages (as compared to the pill):

•  
  • Effectiveness equals that of oral contraceptives
  • Weekly use as opposed to daily use
  • Good cycle control
  • Beneficial acne effect
  • Quick resolve of fertility after use

Disadvantages/Side Effects:

•  
  • Similar to oral contraceptives
  • Breast tenderness (tends to resolve after 3 months)
  • Bleeding (tends to resolve after 3 months)
  • Nausea (tends to reslove after 3 months)
  • Irritation to skin (rotating the site every week will counter this)

Source: Family Planning Council 12/14/2001